Consultas por enfermedades respiratorias agudas en la población pediátrica y su relación con el material particulado atmosférico en Bahía Blanca: un estudio ecológico / Consultations for acute respiratory diseases in the pediatric population and their relationship with atmospheric particulate matter in Bahía Blanca: an ecological study

Introducción. El material particulado (PM) es uno de los contaminantes del aire que mayor implicación tienen en la aparición o exacerbación de cuadros respiratorios en niños. Objetivo. Describir las características de las consultas por enfermedades respiratorias agudas en menores de 15 años, los niveles de PM en el aire, y analizar la asociación existente entre ellos en un sector de Bahía Blanca entre abril de 2019 y marzo de 2020. Población y métodos. Estudio ecológico de series temporales y grupos múltiples. Análisis descriptivo de consultas totales, por área, diagnóstico, y del PM. Modelo de correlación y regresión lineal generalizado para determinar la relación entre las variables. Se utilizó el programa SPSS®. Resultados. Se recopilaron 4787 consultas. Un 38,6 % (1846) correspondieron a rinitis y un 21,1 % (1011) a broncoespasmo. El PM de 10 nm (PM10) superó su valor límite el 31 % (115) de los días de estudio y el de 2,5 nm (PM2,5) un 3 % (8). Un aumento del 10 % del PM2,5 demostró incrementos de 1,3 % en las consultas totales; el incremento llegó al 2,1 % en el área más cercana al sector industrial (p <0,05). En esta última, el aumento del 10 % de los valores de PM10 se asoció al aumento del 1,8 % de las consultas (p <0,05). Conclusión. Se demostró asociación positiva entre las consultas por enfermedad respiratoria aguda y los niveles de PM del aire, sobre todo con el PM2,5 y en el área más cercana al sector industrial.

Introduction. Particulate matter (PM) is one of the air pollutants most involved in the onset or exacerbation of respiratory conditions in children. Objective. To describe the characteristics of consultations for acute respiratory diseases in children younger than 15 years and the levels of PM in the air and to analyze their association in a sector of Bahía Blanca between April 2019 and March 2020. Population and methods. Ecological, time-series study with multiple groups. Descriptive analysis of total number of consultations, by area, diagnosis, and PM. Generalized linear correlation and regression model to determine the relationship among variables. The SPSS® software was used. Results. Data from 4787 consultations were collected. Of these, 38.6% (1846) were related to rhinitis and 21.1% (1011), to bronchospasm. PM of 10 nm (PM10) exceeded its limit value on 31% (115) of the study days, and PM of 2.5 nm (PM2.5), on 3% (8). A 10% increase in PM2.5 showed increases of 1.3% in total consultations; the increase reached 2.1% in the area closest to the industrial sector (p < 0.05). In the latter, a 10% increase in PM10 was associated with an increase of 1.8% in consultations (p < 0.05). Conclusion. A positive association was evidenced between consultations for acute respiratory diseases and PM levels in the air, especially with PM2.5 and in the area closest to the industrial sector.

Association between airborne particulate matter（PM 2.5） concentration and the incidence of allergic rhinitis in Shanghai / 临床耳鼻咽喉头颈外科杂志

Objective:To explore the impact of PM 2.5 concentration in Shanghai on the incidence of allergic rhinitis（AR） in the population, and provide strategies for early warning and prevention of AR. Methods:Collect daily average concentrations of atmospheric pollutants monitored in Shanghai from January 1, 2017 to December 31, 2019, and clinical data of AR patients from five hospitals in Shanghai during the same period. We used a time-series analysis additive Poisson regression model to analyze the correlation between PM 2.5 levels and outpatient attendance for AR patients. Results:During the study period, a total of 56 500 AR patients were included, and the daily average concentration of PM 2.5 was（35.28±23.07）μg/m³. There is a correlation between the concentration of PM 2.5 and the number of outpatient attendance for AR cases. There is a positive correlation between the daily average number of outpatient for AR and levels of PM 2.5 air pollution（（P<0.05）） . We found that every 10 μg/m³ increase in PM 2.5, the impact of on the number of AR visits was statistically significant on the same day, the first day behind, and the second day behind, with the strongest impact being the exposure on the same day. Every 10 μg/m³ increases in PM 2.5, the number of outpatient visits increased by 0.526% on the same day（95%CI 1.000 50-1.010 04）. Conclusion:The atmospheric PM 2.5 concentration in Shanghai is positively correlated with the number of outpatient for AR, and PM 2.5 exposure is an independent factor in the onset of AR. This provides an important theoretical basis for AR.

Ambient fine particulate matter and cardiopulmonary health risks in China / 中华医学杂志(英文版)

In China, the level of ambient fine particulate matter (PM 2.5 ) pollution far exceeds the air quality standards recommended by the World Health Organization. Moreover, the health effects of PM 2.5 exposure have become a major public health issue. More than half of PM 2.5 -related excess deaths are caused by cardiopulmonary disease, which has become a major health risk associated with PM 2.5 pollution. In this review, we discussed the latest epidemiological advances relating to the health effects of PM 2.5 on cardiopulmonary diseases in China, including studies relating to the effects of PM 2.5 on mortality, morbidity, and risk factors for cardiovascular and respiratory diseases. These data provided important evidence to highlight the cardiopulmonary risk associated with PM 2.5 across the world. In the future, further studies need to be carried out to investigate the specific relationship between the constituents and sources of PM 2.5 and cardiopulmonary disease. These studies provided scientific evidence for precise reduction measurement of pollution sources and public health risks. It is also necessary to identify effective biomarkers and elucidate the biological mechanisms and pathways involved; this may help us to take steps to reduce PM 2.5 pollution and reduce the incidence of cardiopulmonary disease.

Caracterización y biomonitoreo de contaminantes orgánicos e inorgánicos en una zona ladrillera de San Luis Potosí / Characterization and biomonitoring of organic and inorganic contaminants in a brick-making area of San Luis Potosí

Resumen El sector ladrillero se caracteriza por la elaboración del ladrillo de forma artesanal donde utilizan técnicas rudimentarias, hornos de baja tecnología y diversos combustibles de poca calidad generando humos negros con gran cantidad de contaminantes. Por lo que el objetivo de este estudio fue caracterizar los metales en suelo, HAPs en aire y biomonitoreo de HAPs en trabajadores de la zona ladrillera "Las Terceras" San Luis Potosí, México. Con el fin de conocer la exposición laboral se determinó la concentración de HAPs en partículas PM10, se caracterizó el suelo de la zona de trabajo y se realizó un biomonitoreo de me-tabolitos hidroxilados HAPs (OH-HAPs) en orina de los trabajadores. En aire se encontraron 14 de los 16 HAPs prioritarios por la Agencia de Protección Ambiental en la fracción de PM10, con una concentración media de 5293,05 gg/m3 (3,11-10510,81). Los resultados del análisis químico de los polvos mostraron que están constituidos principalmente de cuarzo (SiO2) y arcillas (SiAlOx) con presencia de óxidos de Fe-Ti, fosfatos de tierras raras (Lantano, Cerio, Neodimio Torio), silicatos de zirconio, sulfatos de bario, óxidos de zinc. En el biomonitoreo participaron 42 trabajadores ladrilleros, los resultados de la exposición a OH-HAPs en orina demostraron la media total de los OH-HAPs de 15,7 (6,92-195) ng/ml. Estos resultados muestran que el monitoreo ocupa-cional de las zonas ladrilleras es importante debido al escenario de riesgo y a las condiciones precarias de este trabajo, además de la alta exposición a contaminantes que afectan la salud de los trabajadores y sus familias, así como la propuesta de estrategias que ayuden a minimizar los impactos ambientales y prevenir los efectos en salud de las poblaciones.

Abstract The brick-making sector is characterized by artisanal brick production using rudimentary techniques, low-tech kilns and various low-quality fuels that generate black fumes with a large amount of pollutants. Therefore, the objective of this study was to characterize metals in soil, PAHs in air and biomonitoring of PAHs in workers of the "Las Terceras" brick area in San Luis Potosí, Mexico. In order to know the occupational exposure, the concentration of PAHs in PM10 particles was determined, the soil of the work area was characterized and a biomonitoring of hydroxylated PAH metabolites (OH-HAPs) in the urine of the workers was carried out. In air, 14 of the 16 PAHs prioritized by the Environmental Protection Agency were found in the PM10 fraction, with an average concentration of 5293.05 gg/m3 (3.11-10510.81). The results of the chemical analysis of the dusts showed that they are mainly constituted of quartz (SiO2) and clays (SiAlOx) with presence of Fe-Ti oxides, rare earth phosphates (Lanthanum, Cerium, Neodymium Thorium), zirconium silicates, barium sulfates, zinc oxides. The biomonitoring involved 42 brick workers, the results of OH-HAPs exposure in urine showed the mean total OH-HAPs of 15.7 (6.92-195) ng/ml. These results show that occupational moni-toring of brick-making areas is important due to the risk scenario and the precarious conditions of this work, in addition to the high exposure to pollutants that affect the health of workers and their families, as well as the proposal of strategies that help minimize environmental impacts and prevent health effects on populations.

Impact of Air Pollutant on Heart Rate Variability in Healthy Young Adults

Abstract Background: Air pollution and sex independently affect cardiac autonomic control, which can be assessed by heart rate variability (HRV). The research hypothesis is that individuals exposed to low concentrations of pollution have higher cardiac autonomic modulation compared to those exposed to high concentrations and that women have better cardiac autonomic control than men. Objective: To analyze the impact of exposure to air pollutants, specifically smoke, and sex on HRV in healthy young people exposed to different concentrations of pollution over an average period of 22 years. Methods: From April to September 2011, 36 participants of both sexes (20-30 years old) were selected, grouped by levels of air pollution exposure according to indices provided by the Environmental Company of São Paulo State. The R-R intervals (R-Ri) of the electrocardiogram were captured using a heart rate monitor during supine rest. HRV was analyzed by spectral analysis and conditional entropy. The Queen's College step test was used to characterize functional capacity. A between-group comparison was performed using the two-way ANOVA statistical test (post hoc Tukey) and p<0.05. Results: Significant differences were found in mean R-Ri (p<0.01) and cardiac parasympathetic modulation between sexes in the same city (p=0.02) and between groups exposed to different air pollution concentrations (p<0.01). Conclusion: Our results suggest that long-term exposure to air pollutants, specifically smoke, has an unfavorable impact on HRV, with reduced cardiac vagal autonomic modulation in healthy young adults, especially females.

Prevalencia del síndrome del edificio enfermo en trabajadores de la industria manufacturera / Prevalence of sick building syndrome in manufacturing industry workers

El síndrome del edificio enfermo, se refiere a un conjunto de síntomas generales en mucosa (ocular y/o respiratoria) y piel que presentan los ocupantes de edificaciones con calidad ambiental deficientes, exponiendo a sus ocupantes a factores de riesgos físicos, mecánicos, químicos, biológicos y psicosociales, que puede afectar negativamente la salud y productividad de las personas. Con el propósito de determinar la frecuencia de los síntomas de los ocupantes de una industria manufacturera del Perú, se realizó estudio transversal aplicándose a 237 trabajadores, estratificados por áreas laborales, el cuestionario sugerido por el Instituto Nacional de Higiene y Seguridad en el Trabajo, además de evaluar la condición ambiental mediante la determinación de bioaerosoles cultivables y contables. Los resultados mostraron prevalencia superior al 20% en síntomas como: sequedad en ojos y garganta, picor en garganta congestión nasal, dolor de cabeza y debilidad general. Se tomaron, cuantificaron y caracterizaron 164 muestras de bioaerosoles, los microrganismos encontrados con mayor porcentaje fueron, Aspergillus sp. 54,68% (68) en el área administrativa, mientras que en las áreas de producción y almacén predomino Penicillium sp. con 87,10% (108) y 62,21% (77) respectivamente. Otros géneros encontrados en mayor porcentajes, en las tres áreas fueron: Trichoderma, Acremonium, Monilia, Cladosporium, entre otros. Los hallazgos se correlacionan con lo reportado en diversas investigaciones, la presencia de mencionados hongos, sugiere que existe una inadecuada calidad ambiental y aunada a la prevalencia obtenida en cuanto a sintomatología, se puede clasificar la edificación objeto de estudio con el Síndrome del edificio enfermo(AU)

Sick building syndrome refers to a set of general mucosal (ocular and/or respiratory) and skin symptoms presented by occupants of buildings with poor environmental quality, exposing their occupants to physical, mechanical, chemical, biological and psychosocial, which can negatively affect the health and productivity of people. In order to determine the frequency of the symptoms of the occupants of a manufacturing industry in Peru, a cross-sectional study was carried out, applying to 237 workers, stratified by work areas, the questionnaire suggested by the National Institute of Hygiene and Safety at Work, in addition to to evaluate the environmental condition by determining cultivable and countable bioaerosols. The results showed a prevalence greater than 20% in symptoms such as: dry eyes and throat, itchy throat, nasal congestion, headache and general weakness. 164 samples of bioaerosols were taken, quantified and characterized, the microorganisms found with the highest percentage were Aspergillus sp. 54.68% (68) in the administrative area, while in the production and storage areas, Penicillium sp. with 87.10% (108) and 62.21% (77) respectively. Other genera found in higher percentages in the three areas were: Trichoderma, Acremonium, Monilia, Cladosporium, among others. The findings correlate with what has been reported in various investigations, the presence of these fungi suggests that there is an inadequate environmental quality and, together with the prevalence obtained in terms of symptoms, the building under study can be classified with the Sick Building Syndrome(AU)

Cardiovascular and Cerebrovascular Diseases Induced by Air Pollution / 中国医学科学院学报

Air pollution has severe detrimental effects on public health.A substantial number of studies have demonstrated that air pollution exposure is a risk factor for the occurrence of cardiovascular and cerebrovascular diseases and a cause of non-communicable diseases.Both long-term and short-term exposure to air pollution are associated with respiratory diseases,stroke,coronary artery disease,and diabetes.Aiming to better understand the association,we reviewed the latest studies about the association of air pollution with cardiovascular and cerebrovascular diseases,especially stroke,coronary heart disease,arrhythmia,hypertension,and heart failure,and summarized the underlying mechanisms of the health damage caused by long-term and short-term exposure to air pollution.

Desafío del cambio climático y la contaminación del aire / Challenge of climate change and air pollution

Se describen impactos sobre la salud poblacional debido a la contaminación atmosférica y a la temperatura producto del cambio climático. Se ilustra la situación en Chile respecto de algunos indicadores como son los días de altas temperaturas u olas de calor, y la superficie de terreno afectado por incendios forestales. También se sistematizan los principales resultados de estudios ecológicos multicéntricos en los que se ha incorporado información nacional. Estos tuvieron como finalidad estimar el impacto de la temperatura y la contaminación atmosférica por material particulado, monóxido de carbono y dióxido de nitrógeno mediante un enfoque multicéntrico que abarcó varios continentes, países y localidades.

Impacts on population health due to air pollution and temperature caused by climate change are described. The situation in Chile is illustrated with respect to some indicators such as days of high temperatures or heat waves, and the area of land affected by forest fires. The main results of multicenter ecological studies in which national information has been incorporated are also systematized. These were aimed at estimating the impact of temperature and air pollution by particulate matter, carbon monoxide and nitrogen dioxide through a multicenter approach that spanned several continents, countries, and localities.

Contaminación atmosférica y asma en niños / Outdoor air pollution and asthma in children

El asma en niños es una condición prevalente y con un significativo impacto en la calidad de vida del niño y su cuidador. Un alto porcentaje de los niños están expuestos a la contaminación atmosférica, lo que se traduce en un significativo impacto en su salud respiratoria. Los niños son un grupo especialmente vulnerable por razones fisiológicas, medioambientales y de comportamientos propios de la edad. Existe suficiente evidencia que algunos contaminantes atmosféricos son capaces de aumentar los síntomas de asma y desencadenar exacerbaciones en niños asmáticos. También existe evidencia creciente que la exposición prolongada y precoz a contaminantes atmosféricos pueden aumentar el riesgo de desarrollar asma, especialmente los contaminantes relacionados con el tráfico vehicular. Estos efectos adversos disminuyen cuando disminuye la contaminación atmosférica producto de las regulaciones ambientales. Estudios sobre la carga atribuible estiman que un 13% de los nuevos niños asmáticos pueden deberse a la contaminación atmosférica. El sistema respiratorio y el sistema inmunológico del niño están en desarrollo, por lo que exposiciones a contaminantes atmosféricos pueden tener consecuencias de largo plazo. Existen varios mecanismos identificados que apoyan los resultados de los estudios epidemiológicos destacando el daño por estrés oxidativo. Los médicos que atienden niños tienen que tomar en cuenta este conocimiento e incorporarlo a su práctica clínica.

Asthma in children is a prevalent condition with a significant impact on the quality of life of the child and their caregiver. A high percentage of children are exposed to air pollution, which has a significant impact on their respiratory health. Children are a particularly vulnerable group for age-specific physiological, environmental and behavioral reasons. There is sufficient evidence that some air pollutants are capable of increasing asthma symptoms and triggering exacerbations in asthmatic children. There is also growing evidence that early and prolonged exposure to air pollutants can increase the risk of developing asthma, especially traffic-related air pollution. These adverse effects decrease when atmospheric pollution decreases as a result of environmental regulations. Studies on attributable burden estimate that 13% of new asthmatics in children may occur due to air pollution. The respiratory system and the immune system of the child are developing, so exposure to air pollutants can have long-term consequences. There are several identified mechanisms that support the results of epidemiological studies highlighting damage from oxidative stress. Physicians caring for children need to take this knowledge into account and incorporate it into their clinical practice.

Impacto de la contaminación aérea por incendios forestales en la morbimortalidad de la población expuesta / Impact of air pollution by forest fires and the morbidity of the exposed population

La exposición a las emanaciones de incendios forestales es un importante problema de salud pública nacional e internacional. El cambio climático que conlleva sequía y aumento de la temperatura estival aumenta el riesgo y magnitud de los episodios de incendios forestales, generándose grandes incendios cuyas emanaciones pueden afectar a poblaciones distanciadas del epicentro. La asociación entre la exposición a las emanaciones de los incendios forestales, el aumento de las concentraciones de material particulado aéreo y la morbilidad respiratoria (exacerbación de asma y enfermedades respiratorias crónicas) ha sido evidenciada en diversos estudios. Sin embargo, es difícil realizar un metaanálisis de ellos, ya que la metodología empleada es muy disímil. Entre los principales mecanismos de morbilidad se encontrarían: la producción de citoquinas proinflamatorias, la activación endotelial y la disfunción del sistema nervioso autónomo. Ante la exposición al humo de incendios forestales, se produce daño tisular, aumento de los mecanismos protrombóticos, aumento de la presión arterial y cambios en el ritmo cardiaco, que explicaría los efectos cardiovasculares. Los sujetos con patología cardiovascular preexistente podrían tener mayor riesgo cardiovascular; sin embargo, existen factores confundentes en esta asociación. Por otra parte, el posible riesgo cancerígeno con la exposición a estas emanaciones requiere mayores estudios poblacionales.

Exposure to forest fire fumes is a major national and international public health issue. Climate change that leads to drought and increased summer temperature increases the risk and magnitude of wildfires episodes, generating mega-fires whose fumes not only affect the boundary population, but they may become transcontinental. Association between exposure to forest fire fumes, mainly increased concentrations of air born particulate matter and respiratory morbidity (exacerbation of asthma and chronic respiratory diseases) has been evidenced by diverse studies. However, it is difficult to carry out meta-analysis with them since the methodology used is dissimilar. Among the main causes of morbidity have been postulated the production of pro-inflammatory cytokines, endothelial activation and dysfunction of the autonomic nervous system. Occurrence of tissue damage, increased prothrombotic mechanisms, increased blood pressure and changes in heart rate, would explain the cardiovascular effects associated with exposure to smoke from these fires. However, epidemiological outcomes have not been entirely consistent, as the association between cardiovascular morbidity and exposure to wildfire fumes may be mixed with confounding factors. Despite this, patients with pre-existing cardiovascular pathology may be at increased risk. Finally, the potential risk of carcinogen with exposure to these fumes requires further population studies.

Air quality assessment in Southeast Brazil during COVID-19 pandemic and lockdown: report of increased air pollution / Avaliação da qualidade do ar no Sudeste do Brasil durante a pandemia da COVID-19 e do confinamento: relato de aumento da poluição atmosférica / Evaluación de la calidad del aire en el sudeste de Brasil durante la pandemia de COVID-19 y confinamiento: informe de una mayor contaminación del aire

On March 24, 2020, a partial lockdown was decreed in the state of São Paulo, Brazil, as a measure to hinder the spread of COVID-19, which consisted in prohibiting crowding and advising people to stay home, except for urgent or extremely necessary matters. Based on studies performed in other countries, this study aims to assess the impacts of the lockdown on the air quality of five cities in the state of São Paulo. Our study was conducted by using particulate matter and nitrogen dioxide as air quality indicators, and by correlating the contaminants concentrations with weather data. The results showed an increase in these contaminants in all cities within the first weeks after the lockdown compared with the weeks before the decree and with the same period in previous years. This result is inconsistent with the literature. Therefore, a secondary goal was set to investigate the possible cause (or causes) of such deterioration in air quality, which led to the increased number of wildfires. The anomalous dry weather favored the burning of vegetation in agricultural rural areas and in small, vegetated areas near the municipalities, and limited pollution scavenging by rainfall, both of which contributed to higher pollution concentration. We hypothesize the possible effects of worse air quality on the aggravation of COVID-19, but further research is necessary to obtain a complete assessment.

Em 24 de março de 2020, foi decretado confinamento parcial no Estado de São Paulo, Brasil, como medida para desacelerar a disseminação da COVID-19. O decreto consistia na proibição de aglomerações e na recomendação para as pessoas permanecerem em casa, exceto em situações urgentes ou de extrema necessidade. Na esteira de estudos realizados em outros países, o artigo busca avaliar os impactos do confinamento na qualidade do ar em cinco cidades no Estado de São Paulo. Nosso estudo foi realizado com o material particulado e dióxido de nitrogênio enquanto indicadores da qualidade do ar e pela correlação das concentrações dos contaminantes com dados meteorológicos. Os resultados mostraram um aumento desses contaminantes em todas as cinco cidades dentro das primeiras semanas depois do confinamento, comparado às semanas que antecederam o decreto e com o mesmo período em anos anteriores. O resultado é inconsistente com os achados usualmente relatados em outros estudos. Portanto, foi definido um objetivo secundário a fim de investigar a possível causa (ou causas) da piora na qualidade do ar, o que revelou um aumento no número de incêndios. O tempo anormalmente seco favoreceu a queima de vegetação nas áreas agrícolas rurais e em pequenas áreas de vegetação próximas às cidades, além do limitado escoamento da poluição pela chuva, o que contribuiu à maior concentração de poluentes. Os achados sugerem hipóteses sobre os possíveis efeitos dessa situação de pior qualidade do ar sobre o agravamento de casos de COVID-19, porém são necessários mais estudos para uma avaliação completa.

El 24 de marzo de 2020 se decretó un confinamiento parcial en el estado de São Paulo, Brasil, como medida para evitar la propagación de la COVID-19, que consistió en prohibir aglomeraciones de personas y avisar a la gente que permaneciera en casa, salvo para asuntos urgentes o extremadamente necesarios. Siguiendo algunos estudios realizados en otros países, el objetivo de este trabajo es evaluar los impactos del confinamiento en la calidad del aire de ciudades en el estado de São Paulo. Nuestro estudio fue realizado usando material particulado y dióxido de nitrógeno, como indicadores de la calidad del aire, y mediante la correlación de las concentraciones de contaminantes con los datos meteorológicos. Los resultados mostraron un incremento en estos contaminantes en todas las ciudades dentro de las primeras semanas tras el confinamiento, comparando las semanas antes del decreto y dentro del mismo periodo en los años previos. Este resultado es inconsistente con aquellos que han sido informados en otros estudios. Por ello, un objetivo secundario fue investigar la posible causa (o causas) de tal deterioro en la calidad del aire, que conduce a un incremento en el número de incendios. La climatología seca anómala favoreció la quema de vegetación en las áreas rurales agrícolas, y en áreas con poca vegetación cerca de las ciudades, y la eliminación limitada de la contaminación gracias a la lluvia, ambos contribuyeron a una mayor concentración de contaminación. Se especula que los posibles efectos de esta situación de una peor calidad del aire podrían afectar en el agravamiento de los casos de COVID-19, pero son quizás necesarias más investigaciones para conseguir una evaluación completa.

Environmental air pollution: respiratory effects / Poluição do ar ambiental: efeitos respiratórios

ABSTRACT Environmental air pollution is a major risk factor for morbidity and mortality worldwide. Environmental air pollution has a direct impact on human health, being responsible for an increase in the incidence of and number of deaths due to cardiopulmonary, neoplastic, and metabolic diseases; it also contributes to global warming and the consequent climate change associated with extreme events and environmental imbalances. In this review, we present articles that show the impact that exposure to different sources and types of air pollutants has on the respiratory system; we present the acute effects—such as increases in symptoms and in the number of emergency room visits, hospitalizations, and deaths—and the chronic effects—such as increases in the incidence of asthma, COPD, and lung cancer, as well as a rapid decline in lung function. The effects of air pollution in more susceptible populations and the effects associated with physical exercise in polluted environments are also presented and discussed. Finally, we present the major studies on the subject conducted in Brazil. Health care and disease prevention services should be aware of this important risk factor in order to counsel more susceptible individuals about protective measures that can facilitate their treatment, as well as promoting the adoption of environmental measures that contribute to the reduction of such emissions.

RESUMO A poluição do ar ambiental é um dos principais fatores de risco de morbidade e mortalidade global. Ela tem impacto direto na saúde humana, sendo responsável pelo aumento de incidência e de óbitos por doenças cardiorrespiratórias, neoplásicas e metabólicas; também contribui para o aquecimento global e para as consequentes alterações do clima associadas a eventos extremos e aos desequilíbrios ambientais. Nesta revisão, apresentamos artigos que evidenciam o impacto da exposição a diferentes fontes e tipos de poluentes do ar no sistema respiratório; apresentamos os efeitos agudos — como aumento de sintomas e no número de atendimentos em serviços de emergência, internações e óbitos — e crônicos — como o aumento da incidência de asma, DPOC e câncer de pulmão, assim como o declínio acelerado da função pulmonar. Também são apresentados e discutidos os efeitos da poluição atmosférica em populações mais suscetíveis e dos efeitos associados à realização de exercícios físicos em ambientes poluídos. Por fim, apresentamos os principais estudos brasileiros sobre o assunto. Os serviços de atenção à saúde e de prevenção de doenças devem ficar atentos a esse importante fator de risco para orientar indivíduos mais suscetíveis sobre medidas de proteção que possam facilitar seu tratamento, além de estimular a adoção de medidas ambientais que contribuam para a redução dessas emissões.

Early childhood traffic-related air pollution and risk of allergic rhinitis at 2-4 years of age modification by family stress and male gender: a case-control study in Shenyang, China

BACKGROUND@#Few studies have explored the modifications by family stress and male gender in the relationship between early exposure to traffic-related air pollution (TRAP) and allergic rhinitis (AR) risk in preschool children.@*METHODS@#We conducted a case-control study of 388 children aged 2-4 years in Shenyang, China. These children AR were diagnosed by clinicians. By using measured concentrations from monitoring stations, we estimated the exposures of particulate matter less than 10 μm in diameter (PM@*RESULTS@#The prevalence of AR in children aged 2-4 years (6.4%) was related to early TRAP exposure. With an IQR (20 μg/m@*CONCLUSIONS@#Family stress and male gender may increase the risk of AR in preschool children with early exposure to PM

Outdoor air pollution and diminished ovarian reserve among infertile Korean women

BACKGROUND@#Mounting evidence implicates an association between ambient air pollution and impaired reproductive potential of human. Our study aimed to assess the association between air pollution and ovarian reserve in young, infertile women.@*METHODS@#Our study included 2276 Korean women who attended a single fertility center in 2016-2018. Women's exposure to air pollution was assessed using concentrations of particulate matter (PM@*RESULTS@#The mean age was 36.6 ± 4.2 years and AMH level was 3.3 ± 3.1 ng/mL in the study population. Average AMH ratio was 0.8 ± 0.7 and low AMH was observed in 10.3% of women (n=235). The average concentration of six air pollutants was not different between the normal ovarian reserve and low AMH groups for all averaging periods. In multivariable models, an interquartile range (IQR)-increase in 1 month-average PM@*CONCLUSIONS@#In a cohort of infertile Korean women, there was a suggestive evidence of the negative association between ambient PM concentration and ovarian reserve, highlighting the potential adverse impact of air pollution on women's fertility.

Association between exposure to ambient air pollution and hospital admission, incidence, and mortality of stroke: an updated systematic review and meta-analysis of more than 23 million participants

BACKGROUND@#Previous studies have suggested that exposure to air pollution may increase stroke risk, but the results remain inconsistent. Evidence of more recent studies is highly warranted, especially gas air pollutants.@*METHODS@#We searched PubMed, Embase, and Web of Science to identify studies till February 2020 and conducted a meta-analysis on the association between air pollution (PM@*RESULTS@#A total of 68 studies conducted from more than 23 million participants were included in our meta-analysis. Meta-analyses showed significant associations of all six air pollutants and stroke hospital admission (e.g., PM@*CONCLUSIONS@#Exposure to air pollution was positively associated with an increased risk of stroke hospital admission (PM

Effects of Air Pollutants on Outpatient Visits for Atopic Dermatitis in Lanzhou / 中国医学科学院学报

Objective To quantitatively evaluate the associations of PM